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ASCO requests $34.1 billion in federal funding to continue pace of cancer research
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“Robust” federal funding is needed to build on recent advances in cancer research, ASCO’s senior vice president and chief medical officer, Richard L. Schilsky, MD, FASCO, said during a news conference on Capitol Hill on Wednesday.
“Specifically, ASCO is requesting at least $34.1 billion for the National Institutes of Health, including $5.6 billion for the National Cancer Institute in the current fiscal year,” Schilsky said.
ASCO also asked Congress to continue its support of the 21st Century Cares Act, which includes $1.8 billion reserved for the cancer moonshot initiative launched by former vice president Joe Biden.
“Predictable funding increases for the NIH and the NCI are critical to maintaining the pace of scientific discovery, and that pace continues to accelerate,” Schilsky said. “We need to continue to develop and deliver new cancer therapies for the millions of cancer patients who will be diagnosed this year and in years to come.
“We urge Congress to provide robust funding for the federal research enterprise,” Schilsky added. “ASCO is calling on you to finish the work of the appropriations committee and pass a budget to finish out this fiscal year. We understand that may be difficult and may be complicated, but we think it’s absolutely essential.”
Need for more federal funding
For much of the past decade, federal funding for biomedical research has been flat, according to Schilsky. In inflation-adjusted dollars, the NIH budget in 2016 was 20% lower than it was 10 years ago.
“As the funding continues to decline, there are fewer trials and fewer patients who have an opportunity to get into those trials because the budget hasn’t been able to sustain that kind of work,” Schilsky said.
The current budget environment will make it difficult for Congress to deliver the support ASCO has come to expect, representative David E. Price, a senior member of the House Appropriations Committee who serves the fourth district of North Carolina, said during the news conference.
“Unfortunately, with the new administration coming in, we had a decision to hold up ... the fiscal 2017 funding,” Price said. “The omnibus appropriations bill was ready to go at the lame duck session in December and included a budget patch that was critically important for cancer research.
“We’re still under the cloud of probably the worst budget agreement ever made, the Budget Control Act of 2011,” he said.
It is difficult to predict how much funding will go to the NIH, Price said. He said he hopes the moonshot initiative will provide “a little better than just a holding pattern” in funding.
“That does depend on patching the budget and that’s the big question right now,” he said. “What do we do about the rest of 2017? The new administration coming in asked Congress to put a hold on the omnibus appropriations and that was, even from their point of view, a very unwise decision.
“I’m very, very worried we will get a sequestration-level budget from the new administration and that will certainly make bipartisanship impossible in writing these bills, and it basically makes appropriations impossible because it’s one thing to thump your chest about cutting spending; it’s quite another thing to realize what that means is less cancer research,” he added.
Price concluded his remarks by issuing advice to ASCO and its members.
“Don’t let anybody thank you and commend you for the great work you’re doing and say how supportive they are, and then turn around and support a budget that makes funding that work impossible,” Price said. “To be as candid as I can possibly be, that’s exactly what you’re facing.”
How funding helps
In the society’s annual report, “Clinical Cancer Advances 2017: ASCO’s Annual Report on Progress Against Cancer,” ASCO noted that 30% of 2016 advances in cancer research were supported by federal funding and that more than 90 cancer drugs have been approved by the FDA since 2006.
Progress has been evident in survival rates — 68% of adults and 80% of children are diagnosed with cancers that have survival rates that exceed 5 years, up from 50% of adults and 62% of children in 1970.
ASCO also announced today that the society named “immunotherapy 2.0” as its advance of the year, based on the expanding use of this class of drugs and a refined patient selection.
The most significant advances in immunotherapy in recent years have been in immune checkpoint inhibitors, according to ASCO’s report. Since 2011, the FDA has approved 15 uses for immune checkpoint inhibitors, including five in the past year for lung, kidney, bladder, and head and neck cancers, as well as Hodgkin lymphoma. The FDA’s approval of atezolizumab (Tecentriq, Genentech) marked the first new treatment for bladder cancer in more than 3 decades.
Immunotherapy progress in 2016 also focused on identifying patients most likely to benefit from these treatments, discovering mechanisms of resistance, and developing better means of reducing toxicities.
Other cancer-related advances in 2016 noted in ASCO’s annual report were precision medicine, liquid biopsies, and new web-based tools that help patients alert their cancer care teams when symptoms worsen.
In 2016, the FDA approved new precision medicine treatments targeting molecules important in the growth of kidney, lung, breast and blood cancers.
Liquid biopsies also were approved by the FDA, allowing physicians to test circulating plasma tumor DNA in patients with lung cancer. This new technology allows physicians to assess key cancer-driving tumor mutations through a simple blood draw, as opposed to invasive tissue biopsies, facilitating selection of optimal treatment and monitoring changes in the status of the tumor over time.
Despite those advances, Schilsky noted that WHO projects that in 20 years, 22 million people will be newly diagnosed with cancer each year, up from 14 million in 2012, and that cancer deaths will rise from 1.7 million in 2016 to 2.2 million in 2030.
“That’s why we’re pleased to be able to make this announcement here on the Hill, where federal funding has played such a central role in making immunotherapy possible for our patients,” Schilsky said. – by Chuck Gormley